The Role of Plasma in Medicine
The Role of Plasma in the Medical Industry
A very thorough review of the role of plasma in medicine over the past 20 years.
Courtesy of Plasma Processes and Polymers – Version of Record online: 28 OCT 2014; DOI: 10.1002/ppap.201400152; © 2014 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim
With the advent of atmospheric pressure plasma discharges in the early 1990s various industrial and environmental applications that do not require low pressure operating conditions became possible. Among these the biomedical applications of low temperature plasmas took center stage. First, investigations of the efficacy of plasma to inactivate bacteria were conducted in the mid-1990s [1–6] (and references therein). The dielectric barrier discharge (DBD) was the plasma source used during the early studies. Later on, as plasma jets were developed, these were also used with equal success. The inactivation of bacteria on biotic and abiotic surfaces is useful for applications such as sterilization/decontamination [3,4] and wound healing. [5,7]
By the early 2000s, investigations on mammalian cells which showed that under some conditions plasma can affect these types of cells without causing damage were conducted. [8,9] Some of the effects include cell detachment and apoptosis . The period between 2006 and 2013 witnessed two major quantum leaps in medical applications of low temperature plasma (LTP): (i) clinical trials on wound healing were conducted by Isbary et al.;  (ii) LTP was shown to be able to cause damage or even destroy cancer cells in vitro and, later, in vivo, by several investigators. First, Yonson et al. in 2006 tested a human hepatocellular carcinoma (HepG2),  then other adherent and non-adherent cells lines such as melanoma, glioblastoma, and leukemia cells were used by other investigators. [11–23] These crucial advances breathed great confidence and helped cement the idea that LTP could indeed one day revolutionize health care on several fronts.
In this essay, looking back at the last 20 years of efforts, the author’s thoughts on the progress of plasma medicine, and especially on the use of LTP to kill cancer cells, are expressed. These thoughts and opinions include personal reflections and assessment of the field and its prospects for the next decade, especially in regards to the use of LTP in cancer therapy.
2. Historical Perspective: Thoughts and Impressions
It has been about 20 years since the biological and medical applications of low temperature atmospheric pressure plasmas, a field today known as ‘‘Plasma Medicine,’’ had its first humble steps. This author’s group was fortunate enough to take part and contribute to this exciting multidisciplinary field during its two-decade-long ‘‘formative’’ period. Our early work, mid- to late-1990s, focused on investigating the bacterial inactivation efficacy of LTP while in the last few years, 2010 to the present, we have been focusing more on cancer studies.
In between these years, various other topics were entertained and experiments were conducted in our laboratory ranging from wound healing, to destruction of pathogenic proteins that cause neurodegenerative diseases, to dental applications. Each one of these lines of research presented its own set of challenges but also offered many rewarding experiences, the collaboration with biologists, biochemists, and dentists being one of these.
During these two decades this author witnessed the incredible scientific progress that the field of plasma medicine had undergone as many groups around the world entered the field and achieved new research milestones. Most rewarding is seeing many colleagues who were somewhat skeptical early on (understandably hesitant) become some of the most ardent supporters of the field and many of them become some of the most productive.
But regardless of when one enters a research discipline what is important is to positively contribute to the scientific knowledge that is necessary to carry the field forward and many of these colleagues did just that.
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